<!DOCTYPE html>
<html lang="en" xmlns:th="http://www.thymeleaf.org">
	<head>
		<meta charset="utf-8">
		<title>缴费项目</title>
		<link rel="stylesheet" type="text/css" href="css/departmentCss/base.css">
	<link rel="stylesheet" type="text/css" href="css/departmentCss/layout.css">
	<link rel="stylesheet" type="text/css" href="css/departmentCss/zebra_dialog.css">
    <link rel="stylesheet" type="text/css" href="css/appointmentCss/secondary.css">
	<link rel="stylesheet" href="css/charge.css">
	<link rel="stylesheet" href="css/footer.css">
	</head>
	<body>
		<div class="header">
	        <div class="wrapper clearfix">
	            <div class="logo">
	                <a id="headBaseConfigWebTitle" href="javascript:void (0)" style="cursor: text;">青山门诊预约挂号</a>
	            </div>
	        </div>
	    </div>
		<div class="topNav">
	        <div class="wrapper">
	            <div class="topNav_menu">
	                <ul class="clearfix">
	                    <li>
	                        <a id="futureReservation" th:href="@{/department}" >首页</a>
	                    </li>
	                    <li class="last">
	                        <a href="appointment.html">我的中心</a>
	                    </li>
	                </ul>
	            </div>
	        </div>
	    </div>
	    <div class="main" style="height: 500px;">
		    <div class="wrapper clearfix">
		        <p class="mt30 clearfix">
		            <input type="hidden" id="timeType" value="2">
		            <span class="fl"> <a th:href="@{/department}">首页</a>
							&gt; <a href="javascript:void(0)" style="text-decoration: none;cursor: text;"> 缴费项目 </a>
						</span>
		        </p>
		    </div>
		   <div class="shoufei">
			   	<form>
			   		<table>
					<tr>
					<th width="100px" height="40px">患者姓名:</th>
					<td width="100px" height="40px">xxx</td>
					<td width="100px" height="40px">患者性别:</td>
					<td width="100px" height="40px">xx</td>
					<td width="100px" height="40px">患者年龄:</td>
					<td width="100px" height="40px">xx</td>
					</tr>
					
					<tr>
					<th width="100px" height="40px">临床诊断:</th>
					<td width="100px" height="40px" colspan="2">xxx</td>
					<td width="100px" height="40px">所需药品:</td>
					<td width="100px" height="40px" colspan="3">xxx</td>
					</tr>
					
					<tr>
					<th width="100px" height="40px">缴费日期:</th>
					<td width="100px" height="40px">xxx</td>
					<td width="100px" height="40px">是否有医保</td>
					<td width="100px" height="40px">有/无</td>
					<td width="100px" height="40px">xxxx</td>
					<td width="100px" height="40px"></td>
					</tr>
					
					<tr>
					<th width="100px" height="40px">缴费金额:</th>
					<td width="100px" height="40px">xxx元</td>
					<td width="100px" height="40px">缴费进度:</td>
					<td width="100px" height="40px" colspan="3">还需缴纳：xxx元</td>
					</tr>
				</table>
				
				<div class="btn">
					<button  class="chargeBtn">确认缴费</button>
					<button class="cancel">取消</button>
				</div>

			   	</form>
				

		</div>
		
		</div>
	<!-- 	<h2>缴费项目</h2> -->
		<footer class="main-footer">
	        <div class="footer_box">
	            <div class="pull-right hidden-xs">
	                <b>All rights reserved</b>
	            </div>
	            <strong>Copyright &copy; 2021-11 
	                <a href="javascript:void(0)">信工研究院研发部</a>.
	            </strong>  
	        </div>   
		</footer>
		
	</body>
</html>
